Maternal-Fetal Conflict and the Impact of Ectogenesis

This paper explores how ectogenesis (EG), or artificial womb technology, impacts maternal-fetal conflict (MFC), which refers to instances when there are conflicts between the interests of the pregnant woman and the interests of her fetus. After a discussion about the interests of women, pregnant women, and fetuses, five approaches to analyzing the ethics of MFC are presented and then used to analyze the case of a pregnant diagnosed with cervical cancer, before and after the availability of EG. The analysis concludes that, based on appeals to justice, the principle of respect for autonomy, and the rights to bodily integrity and privacy, physicians must respect a woman’s autonomous choice regarding her health and pregnancy. The presence of EG provides an option for pregnant women to pursue the treatment that is in their interests while also promoting the fetus’s interests. However, in the presence of EG, the pregnant woman’s decision-making may be constrained by her fetus’s interests and healthcare needs. Specifically, once the fetus is separate from her body, there may be an obligation on the part of the medical professionals to use the technology and this obligation may override the woman’s preference that it not be used. Medical professionals may have a beneficence-based obligation to the ex utero fetus once it is a distinct patient separate from the previously pregnant woman. Failure to employ EG could constitute medical neglect and violate the Baby Doe Amendments. This paper argues that women are not obligated to undergo a procedure that violates their bodily integrity and inflicts medical harm on them in order to have the fetus removed in order to employ EG, and they should not be pressured to do so for the sake of their fetus’s health even if removal and EG utilization would be in the fetus’s best interest. Others, such as physicians or the State, may be obligated to use EG if it is available to serve the ex utero fetus’s interests, but women should not be required to compromise their interests for the sake of the fetus